Prevalence and risk factors associated with hyperuricemia among working population at high altitudes: a cross-sectional study in Western China

Abstract

Chronic exposure to high altitude may lead to hyperuricemia. We investigated the prevalence of hyperuricemia and its risk factors among employees in high-altitude areas. A cross-sectional survey with cluster sampling was performed at 23 worksites on the Qinghai-Tibet Plateau. Subjects were evaluated by using questionnaires, anthropometric and laboratory measurements, and abdominal ultrasound. A multilevel logistic regression model and restricted cubic spline were used to explore the associated factors of hyperuricemia. Of the 4198 employees included in the study, the age-standardized prevalence of hyperuricemia was 28.1% (95% confidence interval (CI) 26.7-29.5), with 31.9% (95%CI 30.2-33.6) in men and 17.9% (95%CI 15.7-20.1) in women. Hypertension, hyperlipidemia, and a meat-food pattern were positively associated with hyperuricemia in both sexes, while diabetes, shift work, body mass index, non-alcoholic fatty liver disease, and low intake of fruits and vegetables were significantly associated with hyperuricemia only in men. Furthermore, a nonlinear dose-response association between the number of cardiovascular risk factors (CRFs) and hyperuricemia was observed. Compared with those having 0 CRFs, the full-adjusted odds ratios (ORs) and 95%CIs for 1, 2, and ≥ 3 CRFs were 1.76 (95%CI 1.25-2.47), 2.54 (95%CI 1.81-3.55), and 3.05 (95%CI 2.16-4.31) in men, respectively, and 2.13 (95%CI 1.43-3.17), 2.78 (95%CI 1.71-4.53), and 3.13 (95%CI 1.50-6.55) in women, respectively. Hyperuricemia is common in employees at high-altitude areas. However, working at higher altitudes does not mean necessarily higher risk of hyperuricemia, as dietary factors and clustered CRFs are more significant. Thus, workplace-based lifestyle modifications should be promoted.

Keywords: Epidemiology; High altitude; Hyperuricemia; Prevalence; Risk factor; Worksite.